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The incidence of brain metastases (BM) is continuing to grow in the elderly population with lung cancer, but these patients are seriously under-represented in clinical trials. Thus, their treatment is not based on the evidence from randomized prospective studies. Age is a well recognized poor prognostic factor for survival in patients with BM from lung cancer, which is reflected in prognostic scales, but its impact on the patients' prognosis reflected by its value in gradually updated grading indices seems to decrease. The reason for poorer outcomes in the elderly is unknown-it may result from the influence of the age per se, simplified staging work-up and suboptimal treatment in this patient subgroup or the excess toxicity of the aggressive anticancer treatment secondary to the impaired physiological regulation mechanisms and comorbidities. The main goal of treatment of BM is to ameliorate neurological symptoms and delay neurological progression, with the focus on the improvement and maintenance of the patients' quality of life. The possible treatment options for BM from lung cancer are whole-brain radiotherapy, stereotactic radiosurgery, surgery, chemotherapy, targeted therapies and best supportive care. The aim of this review is to summarize the problems related to the management of BM in elderly patients with lung cancer, to analyze the value of the above mentioned treatment options, and to provide an insight into the influence of age-related clinical factors on the patients' outcomes.

Failure to comply with treatment recommendations is very common in patients, but still poorly recognised by doctors. The current practice of using oral therapy on a large scale has been increasingly adopted for cancer patients. Chronic myeloid leukaemia (CML) is just such an example, where the introduction of taking new oral medications, the tyrosine kinase BCR-ABL inhibitors (TKI), has now revolutionised the treatment. The aim of our study was to assess treatment adherence in a group of Polish CML patients (a survey was conducted on 140 patient aged ≥18 years) treated with oral TKI (imatinib, dasatinib and nilotinib) taking into account the following variables: gender, age, education, place of residence, family circumstances and duration of therapy. In addition, we evaluated whether there is a relationship between how patients perceive their level of adherence to treatment recommendations with how subjectively the required dosage regimen was followed. Half the patients admitted to skipping at least one drug dose during the entire course of treatment and 39% did so within their last treatment month. Patients were also found to overestimate their own adherence assessment; around 60% of those missing at least 1 drug dose within the last treatment month believed they ‘always’ followed recommendations. The study demonstrated that adherence deteriorates over time. Furthermore, patients aged >65 years and patients suffering at least one comorbid disease had better adherence (p

Continuous and adequate dosing of antineoplastic drugs is essential for optimal treatment response in patients with hematological cancer. Patient adherence, defined as the extent to which a person's behavior corresponds with the agreed recommendations of a healthcare provider is critical. The results of studies published during last few years revealed that nonadherence is more prevalent than patients and physicians believed. The problem has become more important as many drugs are used outside hospital, on out-patient base with treatment possibly being lifelong. This article provides a review of methods used to assess adherence and factors influencing adherence behavior, with special emphasis on psychological types of patients.

Hailey-Hailey disease, or familial benign chronic pemphigus, is an autosomal dominant genodermatosis. Disease symptoms may contribute to an adverse impact on quality of life and functional limitation and disability. As Hailey-Hailey disease is chronic and frequently recalcitrant to treatment, multiple therapeutic approaches, including surgical options, have been attempted. We describe here three cases of recalcitrant Hailey-Hailey disease that showed long-term improvement with radiotherapy. Axillary lesions were treated with electron beam at an anti-inflammatory dose (energy 6-8 MeV). Patients received 20 Gy in 10 fractions to 90% isodose, at each axilla. No disease recurrence was observed during a 38 months follow-up of the treated sites. The effect of radiotherapy was thus considered to be locally beneficial, but without any positive influence on the general course of the disease.

A cancer diagnosis provides significantly level of emotional distress and discomfort both for patient and his family. They must confront themselves with the new, difficult reality. A cancer-related distress may promote the serious psychic disturbances and influenced negatively the therapeutic process. The good interpersonal relationship between physician and patient clearly decreased the level of fear and depression, improved patient's physical and psychical state. Patients who have good communication with their physician are more prone to good adherence and compliance which are essential for the effective therapeutic process. This article discusses the role of relationship between physician and patient regarding its influence on compliance and provides a review of different types of therapeutic contact and the principles of building the physician-patient relationship.

To assess local control after preoperative radiation and local excision and to determine an optimal radiotherapy regimen.Eighty-nine patients with G1-2 rectal adenocarcinoma3-4 cm; unfavourable cT1N0 (23.6%), cT2N0 (62.9%) or borderline cT2/cT3N0 (13.5%) received 5 × 5 Gy plus 4 Gy boost (71.9%) or 55.8 Gy in 31 fractions with 5-FU and leucovorin (28.1%). Local excision (traditional technique 56.2%, transanal endoscopic microsurgery 41.6%, Kraske procedure 2.2%) was performed 6-8 weeks later. If patients were downstaged to ypT0-1 without unfavourable factors (good responders), this was deemed definitive treatment. Immediate conversion to radical surgery was recommended for remaining patients.Good response to radiation was seen in 67.2% of patients in the short-course group and in 80.0% in the chemoradiation group, p = 0.30. Local recurrence at 2 years (median follow-up) in good responders was 11.8% in the short-course group and 6.2% in the chemoradiation group, p = 0.53. In the total group, a lower rate of local recurrence at 2 years was observed in elderly patients (69 years, median value) when compared to the younger patients; 8.3% vs. 27.7%, Cox analysis hazard ratio 0.232, p = 0.016. A total of 18 patients initially managed with local excision required conversion to abdominal surgery but either refused it or were unfit. In this group, local recurrence at 2 years was 37.1%.This study suggests an acceptable local recurrence rate after preoperative radiotherapy and local excision of small, radiosensitive tumours in elderly patients.

I: High Temperature Stress. Functional Specialization of Plant Class A and B HSFs E. Czarnecka-Verner, et al. The Arabidopsis TCH Genes: Regulated in Expression by Mechanotransduction? J. Braam. The Regulation of GABA Accumulation by Heat Stress in Arabidopsis R.D. Locy, et al. GABA Increases the Rate of Nitrate Uptake and Utilization in Arabidopsis Roots J.M. Barbosa, et al. II: Low Temperature Stress. MAP Kinases in Plant Signal Transduction: Versatile Tools for Signaling Stress, Cell Cycle, and More C. Jonak, et al. The Second Stage of Plant Acclimation to Low Temperatures: The Forgotten Step in Frost Hardening? A. Kacperskla. Genetic Engineering of Biosynthesis of Glycinebetaine Enhances Tolerance to Various Stress A. Sakamoto, et al. III: Salinity Stress. Salt Tolerance at the Whole-Plant Level A.R. Yeo, et al. Plant Homologues to the Yeast Halotolerance Gene HAL3 A. Espinosa-Ruiz, et al. Novel Determinants of Salinity Tolerance N.K. Singh, et al. Progress and Prospects in Engineering Crops for Osmoprotectant Synthesis B. Rathinasabapathi. IV: Drought Stress. Plant AP2/EREBP and bZIP Transcription Factors: Structure and Function C. Nieva, et al. Role of Arabidopsis MYB Transcription Factors in Osmotic Stress E. Cominelli, et al. Gene Expression During Dehydration in the Resurrection Plant Craterostigma plantagineum J.R. Phillips, D. Bartels. Some Physiological and Molecular Insights into the Mechanisms of Dessication Tolerance in the Resurrection Plant Xerophyta viscosa Baker S.G. Mundree, J.M. Farrant. Targets of Modifying Plant Growth and Development by ABA-mediated Signaling A. Himmelbach, et al. V: Signal Transduction. Positional Cloning of A Plant Salt Tolerance Gene L. Xiong, et al. Regulation of Ion Homeostasis in Plants and Fungi J.M. Pardo, et al. Adh as a Model for Analysis of the Integration of Stress Response Regulation in Plants M. Dolan-O'Keefe, R.J. Ferl. Sense and Sensibility: Inositol Phospholipids as Mediators of Abiotic Stress Responses I. Heilmann, et al. VI: Oxidative and Heavy Metal Stress. Manipulation of Glutathione and Ascorbate Metabolism in Plants G.M. Pastori, C.H. Foyer. Cadmium Toxicity in Leaf Peroxisomes from Pea Plants: Effect on the Activated Oxygen Metabolism-Proteolytic Activity L.A. del Rio. Metal-Chelate Reductases and 'Plant MT's' N.J. Robinson, Sadjuga. Evolutionary Responses to Zinc and Copper Stress in Bladder Campion, Silene vulgaris (Moench.) Garcke H. Schat, et al.

Changes in activity of four enzymes associated with the turnover of hydrogen peroxide were monitored during ripening of several fruits. Glycolate oxidase activity increased during ripening in the pulp of pear (Pyrus communis L. var. Bosc), avocado (Persea americana Mill. var. Fuerte), and tomato (Lycopersicon esculentum Mill. var. Rutgers), declined in pear peel, and was not detectable in avocado peel. The changes in glycolate oxidase activity did not correspond to the changes in chlorophyll levels which occurred during ripening. Xanthine oxidase and peroxidase activity also increased during ripening in pear pulp. These changes in enzyme activity followed similar patterns whether expressed in terms of protein content or fresh weight. Catalase in pear pulp showed a continuous decline in activity per gram fresh weight but a slight increase followed by a decline in activity per milligram protein. Previously observed increases in hydrogen peroxide levels in senescent fruit tissue may be related to these chang...

Treatment of intact potato (Solanum tuberosum L.) tubers with acetaldehyde, ethanol or acetic-acid vapors led to a respiratory upsurge which was further increased when the volatiles were applied in 100% O2. Mitochondria from tubers held in 100% O2 (O2 control) displayed a substrate state, state 3, and state 4 in respiration, whereas in mitochondria from the volatile-treated tubers the respiratory rate of the different states was virtually indistinguishable. This respiratory pattern was companied by the development of a cyanide-resistant respiration since these mitochondria exhibited resistance to CN and sensitivity to CN+salicylhydroxamic acid. Acetaldehyde-treated potatoes showed a time-course development (up to 36 h) of cyanide resistance and concomitant sensitivity to salicylhydroxamic acid, indicating the onset of synthetic processes leading to the observed changes in mitochondrial respiration.

Several peroxidase fractions were separated by disc electrophoresis of extract of apple seed embryos. Three fractions of slowest electrophoretic mobility showed little substrate specificity, did not change during seed development and were not influenced by plant hormones. The appearance of the faster moving peroxidases was stimulated by gibberellin and benzyladenine, inhibited by abscisic acid and coumarin and unaffected by indolylacetic acid. The stimulation of those peroxidases by gibberellin, strong in dormant apple embryos, diminished during seed after-ripening.

Mitochondria from whole potatoes (Solanum tuberosum) ordinarily fail to oxidize respiratory substrates and to consume molecular O(2) in the presence of cyanide. Mitochondrial preparations obtained from tubers previously held for 24 hours in ethylene (10 microliters per liter) in air are only partially inhibited by cyanide. Application of ethylene in 100% O(2) led to an additional increase in the resistance of the mitochondrial respiration to cyanide. The resistance to cyanide was accompanied by a decrease in the respiratory control but no change in oxidative phosphorylation as shown by the measurement of ATP synthesis.The development of resistance to cyanide following the application of ethylene appears to require whole tubers and may represent an inductive process.

Ethylene, cyanide gas, and volatalized ethanol, acetaldehyde, and acetic acid were applied in a continuous flow to whole potato tubers. Freshly cut slices were obtained periodically during the treatment, and showed a progressive development of a cyanide-resistant respiration. The application of the employed volatiles in 100% O 2 accelerated the onset and the magnitude of the cyanide-resistant respiration. These results show that, similar to ethylene and cyanide, the application of ethanol, acetaldehyde, or acetic acid can also lead to the development of cyanide-resistant respiration in whole potato tubers, and that this type of respiration is retained in freshly cut slices.

Treating intact white potato (Solanum tuberosum L.) tuber with ethylene in air or O(2) made it possible to obtain freshly cut slices which exhibit cyanide-resistant respiration. The cyanide-resistant path requires induction in whole tubers. The data also indicate that high O(2) concentration is necessary for the full development of cyanide-resistant respiration.